Hypogonadotropic hypogonadism

Hypogonadism mamiriro ezvinhu umo miedzo yemunhurume kana mazai echikadzi inoburitsa mashoma kana asina mahormone ebonde.

Hypogonadotropic hypogonadism (HH) chimiro che hypogonadism icho chinokonzerwa nedambudziko nepituitary gland kana hypothalamus.

HH inokonzerwa nekushaikwa kwemahormone ayo anowanzo kumutsa maovari kana testes. Aya mahormone anosanganisira gonadotropin-inosunungura mahormone (GnRH), follicle inosimudzira mahormone (FSH) uye luteinizing hormone (LH).

Kazhinji:

• Iyo hypothalamus muuropi inoburitsa GnRH.
• Iyi hormone inokurudzira iyo pituitary gland kuburitsa FSH neLH.
• Aya mahormone anotaurira mazai echikadzi kana echirume testes kuti abudise mahormone anotungamira mukukura kwepabonde mukuyaruka, zvakajairika kumwedzi, mazinga eestrogen uye kubereka muvakadzi vakuru, uye zvakajairika kugadzirwa kwe testosterone nekugadzirwa kwourume muvarume vakuru.
• Chero shanduko mune ino dhizaini yekuburitsa cheni inokonzera kushomeka kwebonde mahormone. Izvi zvinodzivirira kukura kwese pabonde muvana uye neyakajairika mashandiro emachende kana mazai muvakuru.

Pane zvikonzero zvakawanda zveHH:

• Kukuvadza kune pituitary gland kana hypothalamus kubva pakuvhiya, kukuvara, bundu, hutachiona, kana radiation
• Kuremara kwemajini
• Dosi yepamusoro kana kushandiswa kwenguva refu kwemopioid kana steroid (glucocorticoid) mishonga
• High prolactin level (kemikari yakaburitswa nepituitary)
• Kunetseka kwakanyanya
• Zvinetso zvehutano (zvese zvinokurumidza kuwedzera uremu kana kurasikirwa uremu)
• Yenguva refu (isingagumi) hosha dzekurapa, kusanganisira kusingaperi kuzvimba kana hutachiona
• Kushandisa zvinodhaka, zvakadai seheroin kana kushandisa kana kushungurudzwa kwemishonga inonyorwa yaunopihwa
• Zvimwe zvehutano mamiriro, senge kuwandisa kwesimbi

Kallmann syndrome inzira yakagara nhaka yeHH. Vamwe vanhu vane chirwere ichi vane anosmia (kurasikirwa kwekunzwa kwekunhuhwira).

Vana:

• Kushaikwa kwekukura pakuyaruka (kukura kunogona kunonoka kana kusakwana)
  
• Mune vasikana, kushomeka kwekukura kwezamu uye kumwedzi
• Muvakomana, hapana kukura kwehunhu hwepabonde, sekuwedzera kwema testes nepenisheni, kuwedzera kwezwi, uye bvudzi kumeso.
• Kusakwanisa kunhuwidza (mune zvimwe zviitiko)
• Pfupi chimiro (mune zvimwe zviitiko)

Vakuru:

• Kurasikirwa kwechido pabonde (libido) muvarume
• Kurasikirwa kwekuenda kumwedzi (amenorrhea) mumadzimai
• Yakadzikira simba uye kufarira zviitiko
• Kurasikirwa kwemhasuru mumarume
• Kurera huremu
• Maitiro anochinja
• Kushaya mbereko
  

Anopa hutano anoita bvunzo dzepanyama uye obvunza nezve zviratidzo zvako.

Miedzo inogona kuitwa inosanganisira:

• Ropa bvunzo kuyera mahormone mazinga seFSH, LH, uye TSH, prolactin, testosterone uye estradiol
• LH kupindura GnRH
• MRI yepituitary gland / hypothalamus (kutsvaga bundu kana kumwe kukura)
• Kuongorora genetic
• Ropa bvunzo kutarisa iron level

Kurapa kunoenderana nekwanisi chechinetso, asi kunogona kusanganisira:

• Majekiseni e testosterone (muvarume)
• Inononoka-kusunungura testosterone ganda chigamba (muvarume)
• Testosterone gels (mune varume)
• Estrogen uye progesterone mapiritsi kana zviganda zveganda (mune vanhukadzi)
• GnRH majekiseni
• HCG majekiseni
  

Kurapa kwakanaka kwehormone kunokonzera kuti kuyaruka kutange muvana uye kunogona kudzorera kubereka muvakuru. Kana mamiriro acho akatanga mushure mekuyaruka kana mukukura, zviratidzo zvinowanzo gadziridzwa nekurapwa.

Matambudziko ehutano anogona kukonzerwa neHH anosanganisira:

• Kunonoka kuyaruka
• Kutanga kuenda kumwedzi (muvakadzi)
• Kushaya mbereko
• Kuderera kwepfupa uye kutsemuka gare gare muhupenyu
• Kuzvidzora kwakaderera nekuda kwekutanga kunonoka kwekuyaruka (kutsigirwa nemanzwiro kunogona kubatsira)
• Zvinetso zvebonde, senge yakaderera libido

Fonera mupiki wako kana:

• Mwana wako haatangi kuyaruka panguva yakakodzera.
• Iwe uri mukadzi ari pasi pemakore makumi mana uye yako yekuenda kumwedzi inomira.
• Wakarasikirwa muhapwa kana bvudzi repabhawa.
• Iwe uri murume uye wakadzikisa kufarira bonde.

Gonadotropin kushomeka; Sekondari hypogonadism

• Endocrine masero
• Pituitary shwanu
• Gonadotropin

Bhasin S, Brito JP, Cunningham GR, uye al. Testosterone therapy mune varume vane hypogonadism: iyo Endocrine Society kiriniki yekudzidzira nhungamiro. J Clin Endocrinol Metab. 2018; 103 (5): 1715-1744. PMID: 29562364 www.ncbi.nlm.nih.gov/pubmed/29562364.

Styne DM, Grumbach MM. Physiology uye kusagadzikana kwekuyaruka. Mune: Melmed S, Polonsky KS, Larsen PR, Kronenberg HM, eds. Williams Chinyorwa cheEndocrinology. 13 ed. Philadelphia, PA: Elsevier; 2016: chits. 25.

Chena PC. Kukura pabonde uye kuzivikanwa. Mune: Goldman L, Schafer AI, eds. Goldman-Cecil Mushonga. 26th ed. Philadelphia, PA: Elsevier; 2020: chits. 220.